Organised By
Organised By
1 Department of Life Sciences, University of Roehampton, London
2 Academic Division of Diabetes, Endocrinology and Metabolism, Hammersmith Hospital, Imperial College London
^ Currently with Department of Nutrition & Dietetics, International Medical University, Malaysia.
Corresponding author: SooLayTeo@imu.edu.my
Abstract
Background: Obesity surgery is an effective intervention for weight loss and type 2 diabetes mellitus (T2DM). However, not all who undergo surgery acquires its full benefits. This study aims to phenotype the eating behaviour of T2DM patients with poor weight loss outcomes after undergoing Roux-en-Y gastric bypass (RYGB) or vertical sleeve gastrectomy (VSG).
Methods: Diabetes remission scores (DiaRem) for suboptimal responders were calculated. They underwent a mechanistic test which included a dietary recall, sensory domain assessment of taste detection using the method of constant stimuli, sweet taste preference test and eating behaviour questionnaires.
Results: Eight RYGB and 3 VSG patients were enrolled. The total percentage weight loss previously achieved was 23.1±7.0%. In those assessed, 6 had high DiaRem scores. Patients ate 1310.9±149.6kcal/day, comprising of 43.6%, 17.7% and 38.7% of carbohydrate, protein and fat respectively. Their detection threshold (EC50) was 0.009mol/l of sucrose, and their ideal concentration of sweetness was 0.11mol/l. Patients expressed ‘disliking’ to all tastant concentrations. Weight was positively correlated to disinhibition (r = 0.789, n =11, p <0.01) and emotional eating (r =0.779, n =11, p <0.05).
Conclusion: T2DM patients with suboptimal weight loss have higher DiaRem scores and dietary intake which deviated from the dietary guidelines for macronutrient composition. They possess higher sweet taste detection thresholds, poorer eating behaviour and psychological health compared to good responders.
Keywords: Obesity surgery, eating behaviour